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South Carolinians need to get ready for Obamacare

STAFF PHOTO BY DEDE BLES
Katherine Nelson Todd, center, and Sam Monroe, right, were the speakers during the Greater Aiken Chamber of Commerce’s “Affordable Health Care Act -- Rumor vs. Reality” program on Tuesday. Also pictured is John McMichael of Hutson-Etherredge Companies, which was the program’s corporate sponsor.

Some local residents and business owners might think the Patient Protection and Affordable Care Act doesn’t apply to them, but they are wrong.

“The truth is that everybody has to comply despite the fact that South Carolina opted out of forming a state-run health insurance marketplace,” said Katherine Nelson Todd, who is a community relations manager for Consumers’ Choice Health Plan.

Todd discussed the health care act – also known as Obamacare – on Tuesday during the Greater Aiken Chamber of Commerce’s “Affordable Health Care Act – Rumor vs. Reality” program. Hutson-Etherredge Companies was the corporate sponsor of the event, which was held at USC Aiken’s Convocation Center.

President Barack Obama signed the Affordable Care Act into law in March 2010.

“The purpose was to decrease the number of uninsured Americans and to reduce the overall cost of health care,” Todd said.

Uninsured South Carolinians will use the federally facilitated health insurance marketplace to learn about plans and to obtain coverage. The marketplace can be found online at www.HealthCare.gov. The Small Business Health Options Program also can be found on the same website.

Open enrollment is scheduled to begin on Oct. 1, but the coverage provided by the plans selected won’t start until Jan. 1, 2014. The open enrollment period ends on March 31, 2014.

Virtually all Americans will be required to have insurance coverage that meets the qualifications of the Affordable Care Act. The penalty for not having insurance for an adult in 2014 will be $95 or 1 percent of that person’s income. As time goes on, the dollar amount and the percentage of income will go up, Todd said.

Todd also talked about how the www.HealthCare.gov website will work.

“You’ll be able to create an account, and you’ll be able to choose a (health insurance) plan and enroll in that plan,” she said. “As part of the process, you’ll enter some IRS data, and you’ll be able to determine if you qualify for a subsidy or a tax credit.”

The website will have a list of health insurance plans along with ratings based on quality and price. They will be presented in a standardized format, and there will be platinum, gold, silver and bronze plans, according to Todd.

The platinum plan will pay, on average, 90 percent of an individual’s health care costs and “the natural assumption is that it will be the most expensive plan,” Todd said. Gold will pay 80 percent, silver will pay 70 percent and bronze will pay 60 percent.

“A catastrophic plan also will be offered for those 30 and younger, and it will be the least expensive of all,” Todd said.

Some people will be pleasantly surprised learn that they qualify for a subsidy or a tax credit, according to Todd.

“If you are an individual, are actively working, have a household size of three and have a family income from $19,350 up to $78,120, you will earn a subsidy to buy your insurance,” she said. “If you happen to fall within the 100 percent to 200 percent range of the federal poverty level, you also will receive a benefit subsidy. So, for example, if your plan has a $2,000 deductible, it may be brought down to about $500.”

Sam Monroe, a group and individual marketing representative for BlueCross BlueShield of South Carolina, focused on Obamacare’s impact on businesses in his presentation.

For health insurance purposes, the federal government considers a small business to be one with 50 or fewer “full-time equivalent” employees. In 2016, the small business qualification will change to 100 or fewer, Monroe said.

Small business owners can purchase health insurance coverage for their employees through the Small Business Health Options Program. However, small businesses that don’t offer their workers coverage won’t be penalized. Penalties for larger businesses that don’t offer coverage won’t begin until 2015.

Dede Biles is a general assignment reporter for the Aiken Standard and has been with the newspaper since January 2013. A native of Concord, N.C., she graduated from the University of North Carolina at Chapel Hill.

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